William Boyd - The Blue Afternoon

'What's this ward for?'

'Only chest wounds. Dr Cruz has asked that this be kept exclusively for chest wounds.' Sister Encarnacion looked unhappy. 'We get too many criminals, Dr Carriscant. The police from Tondo bring them here when they are injured in fights. Dr Cruz has asked only for those with chest wounds. The worst sort of individual… ' She lowered her voice. 'We're not used to this in the San Jeronimo. Not at all.'

It was only as he approached the rear of the Sieverance house that Carriscant's thoughts turned to something other than Dr Isidro Cruz and his daring new operations. He had hired a carromato to take him to Uli-Uli, a village just beyond the Palace, and had trudged back towards the Calle Lagarda before leaving the road and making his way across country towards the cul de sac and its sumptuous residences. The sky was largely covered but from time to time a three-quarter moon appeared between the shreds of cloud to light his way. He reached the rear hedge bordering the Sieverance garden without serious mishap. One slithering fall down the banked dyke of a rice paddy had soaked a shoe and muddied a trouser leg, but otherwise he was in good order as he pushed his way through the thick cogal and hibiscus bushes and crept across the moon washed garden towards the house.

And once again he asked himself what exactly he was hoping to achieve and as always the realisation came that it was the effort itself that provided the justification. It was inertia that finished him: to be doing something, however pointless, however foolish, was crucial. So he took up his position behind a dense humped mass of bougainvillaea that had engulfed a wooden pergola and waited. Perhaps she would venture out on to the azotea for some fresh air and he would be able to call discreetly to her. Even to glimpse her would be sufficient reward. He could see that many of the house's rear windows were illuminated and he could hear the chatter of servants and the clanging of pots and utensils from the ground-floor kitchen area. The evening meal over, he guessed. He was sure he knew where her bedroom was, and also the library, but he felt it would be foolhardy to throw a pebble at either of these windows in the hope of attracting her attention. What if a maid was in the room? Or worse, Nurse Aslinger? He had better wait and pray his luck would hold.

Occasionally, he saw shadows pass in front of the screened windows but they were too vague and diffuse to make identification possible. And then he heard some piano music – that must be her, he thought – a series of arpeggios against a held note, then a haunting snatch of melody, some quickly played scales, up and down, and then silence. More shadows flicked in front of the windows and the fancy entered his mind that she was pacing about the rooms of the house, restless, her mind working, unable to settle, thinking about him just as he was thinking about her. Perhaps his very presence in the garden, his proximity, was provoking this delicious edginess… He concentrated hard, sending his thought-waves out, willing her to open a door and step out on to the rear terrace. But she did not appear. He heard a door slam, saw the light go out in what he took to be her bedroom and then nothing more. The wetness in the grass soon soaked through his remaining dry sole and he felt the cooler breezes on his neck carrying with them the earth-reek that warned of approaching rain. It began to drizzle steadily and in the next-door garden a dog started to bark tetchily, setting off another in the servants' quarters of the Sieverance house. It was time to leave. He felt oddly satisfied as he renegotiated his way through the hedge and regained the road. In anyone else's eyes his damp vigil in the garden would have seemed absurd and a futile waste of time, but to a lover, he said to himself as he tramped into San Miguel looking for a carromato, to a lover such needless discomfort has its own private import, signalling the depth of his devotion. The tune, the melody she had briefly played, remained in his head. He found he was still humming it as he settled down in his divan bed and prepared for sleep.

Carriscant was tidying away his papers into his desk when there was a knock at his door and one of the nursing sisters appeared.

'Excuse me, Dr Carriscant, Dr Cruz sends his compliments and would like you to visit him in his theatre. It's a matter of some urgency.'

Carriscant was very surprised. He and Cruz had barely exchanged a word since the row over Delphine's appendicitis.

'In his theatre, you say?'

'Yes. At once, if you please.'

Carriscant crossed the courtyard towards Cruz's consulting rooms. He followed the nurse down an ill-lit corridor towards the operating theatre. The walls here were painted with ancient yellow distemper which was flaking and peeling, and there was a curious smell in the air, a sweetish fatty cloying reek which lingered in the nose, coating the palate almost as if it were designed to be tasted rather than smelt. It was the smell of old untended food, an exudation of dirty kitchens. Carriscant recognised it at once as the smell of putrefaction.

Cruz's operating theatre was, to Carriscant's eyes, a scene from one of the circles of hell. Old cracked terracotta tiles on the floor and smudged plaster walls covered, for some reason, in scribbles of handwriting, ancient wooden trays and tables. Cruz stood tall in his domain, in his famous frock coat with its filthy veneer, its pustulent lichen, the cuffs unbuttoned and the sleeves of his coat and shirt folded back to reveal his powerful forearms with their pelt of dark hair. His hands were smeared with blood as he towelled them off on a scrap of cloth. Three theatre nurses stood around the operating table alongside another doctor, Dr Filomeno, who acted as Cruz's anaesthetist. Dr Filomeno wore a light brown suit, ruined by a splash of blood down the right side. He was dabbing at this with a bundle of swabs and complaining vigorously to one of the nurses.

'Ah, Carriscant,' Cruz said, tossing the towel away on to a tray of instruments. 'Glad you could make it.' The self-satisfaction, the barely suppressed delight in his voice, made him drawl the words out as if he were intoxicated. 'I very much wanted you to see this.' He waved Carriscant up to the table.

A man lay there, his chest cavity open, retractors holding the wound wide. Peering closer, Carriscant could see that the pericardium had also been cut open, the sides held back by clamp forceps.

'Look,' Cruz said. There, amidst the coagulated blood and the severed tissue Carriscant saw the man's beating heart, pulsing irregularly like some sea creature, half vegetable, half shell-less bivalve, something that clung to rocks deep at the bottom of the sea, expanding and contracting weakly, only just alive. Carriscant turned back to Cruz. The man ran his hands through his wiry hair and began to roll down his cuffs.

'I've summoned a photographer,' he said proudly. 'The world is about to learn about Isidro Cruz. You're not the only surgeon around here that can make an impression.'

'What're you talking about?'

'Look,' Cruz said, approaching the body. 'Just look, Carriscant.'

He stared at the twitching heart. Six taut sutures, knotted silk. Cruz's blunt finger entered the chest cavity and touched the pulsing organ.

'Cardiac sutures, Carriscant. In a knife wound.'

The nurses fussed over the body, checking the drains from the pericardium and pleura.

'Dr Filomeno will replace the rib and close the wound. I shall be issuing a statement to the press.'

Carriscant could not resist it: he reached out a finger and gently touched the surface of the beating heart as it wobbled and bulged, slick in its cavity. The six stitches sealed a neat wound about an inch long in the left ventricle. Carriscant's eye fell on a bag of ice on a nearby trolley. He looked at the man's face.